No abstract available.
Female ; Humans ; Hysterosalpingography* ; Laparoscopy*

BACKGROUND: Positive end expiratory pressure (PEEP) ventilation is well established as an integral part of the management of patients with the acute lung injury. PEEP is a key element in the treatment of hypoxemia resulting from pulmonary edema. Pulmonary capillary pressure (Pcap) is the most important factor influencing lung edema formation, and an understanding of how Pcap is altered by variations of PEEP or pulmonary arterial occlusion pressure (PAOP) is important to improve the treatment of acute lung injury patients. This study was performed to evaluate the effects of PEEP on the pulmonary capillary pressure in acute lung injury patients. METHODS: This was a prospective study of 11 acute lung injury patients. The effect of PEEP on pulmonary circulation at four different levels (0,4,8, and 12cm H2O) was analyzed. Pcap was estimated visually at bed side with Swan Ganz catheters. The pulmonary vasculature was analyzed by calculating the pressure difference at the arterial and venous parts of the circulation. RESULTS: As PEEP increased from 0 to 12 cm H2O, the mean puhnonary arterial pressure (PAP) and Pcap increased respectively from 22.7 ± 7.4 to 25.3 ± 7.3 mmHg and 15.3 ± 3.3 to 17.8 ±3.2 mmHg (p<0.05). Similarly, PAOP increased from 9.8 ± 2.1 to 12.8 ± 2.1 mmHg and the central venous pressure increased from 6.1 ± 1.6 to 9.3 1: 2.3 mmHg(p<0.05). However, the pressure gradient at the arterial (PAP-Pcap) and venous (Pcap-Pcwp) part of pulmonary circulation remained unchanged at all evaluated PEEP levels. CONCLUSION: Although Pcap increasoo gradually with increased PEEP, the pressure gradient at the arterial and venous part of the pulmonary vasculature remained unchanged at all evaluated PEEP levels in acute lung injury patients.
Acute Lung Injury* ; Anoxia ; Arterial Pressure ; Capillaries* ; Catheters ; Central Venous Pressure ; Edema ; Humans ; Lung ; Positive-Pressure Respiration* ; Prospective Studies ; Pulmonary Circulation ; Pulmonary Edema ; Ventilation

Renal thromboembolism almost always occurs in the setting of cardiac disease. Acute renal infarction may occur rarely in middle-aged patients without apparent risk factors for cardiac thromboembolism. We report a 40-year-old man who developed bilateral renal infarction and had no cardiovascular risk factors, except smoking. In middle-aged healthy patients with renal colic without lithiasis, the diagnosis of idiopathic renal infarction should be considered, especially if lactate dehydrogenase is elevated.
Adult ; Heart Diseases ; Humans ; Infarction ; Kidney ; L-Lactate Dehydrogenase ; Lithiasis ; Renal Colic ; Risk Factors ; Smoke ; Smoking ; Thromboembolism

PURPOSE: To evaluate the feasibility and clinical efficacy of transrectal drainage of a deep pelvic abscess using combined transrectal sonographic and fluoroscopic guidance. MATERIALS AND METHODS: From March 1995 and August 2004, 17 patients (9 men; 8 women; mean age, 39years) suffering from pelvic pain, fever and leukocytosis were enrolled in this retrospective study. Ultrasound (US) or computed tomography (CT), which was obtained prior to the procedure, showed pelvic fluid collections that were deemed unapproachable by the percutaneous transabdominal routes. Transrectal drainage of the pelvic abscess was performed under combined transrectal sonographic and fluoroscopic guidance. The causes of the deep pelvic abscess were postoperative complications (n=7), complications associated with radiation (n=3) and chemotherapy (n=1) as well as unknown causes (n=6). A 7.5-MHz end-firing transrectal US probe with a needle biopsy guide attachment was advanced into the rectum. Once the abscess was identified, a needle was advanced via the biopsy guide and the abscess was punctured. Under US guidance, either a 0.018"or 0.035" guidewire was passed through the needle in the abscess. Under fluoroscopic guidance, the tract was dilated to the appropriate diameter with sequential fascial dilators, and a catheter was placed over the guide wire within the abscess. Clinical success of drainage was determined by a combination closure of the cavity on the follow up images and diminished leukocytosis. The technical and clinical success rate, complications, and patient's discomfort were analyzed. RESULTS: Drainage was technically successful in all patients and there were no serious complications. Surgery was eventually performed in two cases due to fistular formation with the rectum and leakage of the anastomosis site. The procedure was well tolerated in all but one patient who complained of discomfort while the catheter was inserted. The catheter did not interfere with defecation and there was no incidence of catheter expulsion by defecation. CONCLUSION: Transrectal drainage of deep pelvic abscesses using ultrasound and fluoroscopic guidance is a safe, feasible procedure that is well tolerated by patients and is relatively easy to perform.
Abscess* ; Biopsy ; Biopsy, Needle ; Catheters ; Defecation ; Drainage* ; Drug Therapy ; Female ; Fever ; Follow-Up Studies ; Humans ; Incidence ; Leukocytosis ; Male ; Needles ; Pelvic Pain ; Postoperative Complications ; Rectum ; Retrospective Studies ; Ultrasonography*

OBJECTIVE: This study was performed to evaluate the influence of maternal age on embryo quality and the frequency of multiple pregnancy in IVF-ET program. METHOD: 86 conventional IVF-ET cycles were divided into three groups according to the age by 5 year (group A: 26-30, group B: 3135, group C: 36-40 yrs). The in vitro fertilization and development outcome (fertilization, cleavage and high quality embryo rate) and the pregnancy outcome (pregnancy, implantation, G-sac/high quality embryo and multiple pregnancy rate) were examined. And then, these results were compared among the groups. RESULTS: The rates of fertilization (62.7, 68.5 and 65.4%, respectively) and cleavage (95.6, 97.6 and 98.0%, respectively) were not different among the groups. And the high quality embryo (HQE) rate also was not different among the groups (61.8, 62.9 and 62.8%, respectively). The pregnancy rate of group C (23.3%) was significantly lower than that of group A (41.2%) and B (48.7%). And the implantation rate was significantly decreased to group B (32.2%) and C (14.3%) when compared to group A (71.4%) and B (36.8%). CONCLUSION: The pregnancy rate was significantly decreased over 35 years. The G-sac/HQE and multiple pregnancy rate were significantly high below 31 years. Thus, these results suggest that the number of high quality embryo transferred should be limited by the age and another criteria for embryo quality evaluation were required for single embryo transfer.
Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro ; Maternal Age* ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Pregnancy, Multiple* ; Single Embryo Transfer

No abstract available.
Iliac Artery* ; Nephrosis, Lipoid* ; Thrombosis*

PURPOSE: To describe the CT findings of primary liposarcoma of the mediastinum, and to correlate these with the pathologic findings. MATERIALS AND METHODS: We retrospectively reviewed the medical records, chest radiographs and CT scans of four male patients with histopathologically proven primary liposarcoma of the mediastinum treated between September 1996 and April 2002. The CT scans were analyzed by two radiologists, and final decisions were reached by consensus. They were analysed in terms of tumor size and location, enhancement pattern, the pattern of the fat component, calcification, mass effect, pleural effusion, lymph node enlargement, pericardial effusion, tumor extension to the costophrenic junction, and adjacent organ invasion. RESULTS: All patients presented with dyspnea and chest pain. Pathologic subtypes, which were well-differentiated and pleomorphic, were myxoid (n=2) and mixed (n=2). The transverse diameter of the mass ranged from 10.5 to 21 cm. All tumors were located in the anterior mediastinum, and all had lobulated margins. Soft-tissue attenuation predominance (n=2) occurred in the myxoid type, and roughly equal amounts of fat and soft-tissue attenuation (n=2) were present in the mixed type. A small area at calcification was seen in the mixed type (n=1). Mass effect on mediastinal structures was demonstrated in all patients. In three patients, the tumor draped around and conformed to the shape of the costophrenic junction. Chest wall invasion occurred in one patient. CONCLUSION: Findings of an anterior mediastinal location, fat attenuation, mass effect, the invasion of adjacent organs, and a lobulated margin strongly suggested mediastinal liposarcoma. CT attenuation of the lesions correlated closely with the degree of histologic differentiation.
Chest Pain ; Consensus ; Dyspnea ; Humans ; Liposarcoma* ; Lymph Nodes ; Male ; Mediastinum* ; Medical Records ; Pericardial Effusion ; Pleural Effusion ; Radiography, Thoracic ; Retrospective Studies ; Thoracic Wall ; Tomography, X-Ray Computed

Anodic spark deposition method(ASD) surface treated titanium implant possesses a considerable osteoconductive potential that promoting a high level of implant osseointegration in normal bone. The purpose of this study was to observe the ASD implant's osseointegration in the osteoporosis-induced animal model. Twenty four rats, 10 weeks of age, were ovarectomized and 5 weeks later divided into two groups : ASD implant group and control implant group. Titanium screw implants (diameter; 2.0 mm, length, 3.5 mm; pitch-height, 0.4 mm) were designed for this study. Experimental implants were ASD treated and no treatment on control implants. ASD implants and control implants were placed in to left tibiae of rats. The rats were sacrificed at different time interval(1, 2, 4 and 8 weeks after implantation) for histopathologic observation and immunohisto -chemistrical observation, with collagen type I, fibronectin, integrin alpha2beta1 and integrin alpha5beta1 antibodies. The results obtained from this study were as follow: 1. Histopathologic findings, overall tissue response and the pattern of bone formation in both groups were similar. In ASD group, more newly formed bone was seen at 1 week and 2weeks than control group. 2. The levels of type I collagen and fibronectin expression were the most abundant at 2weeks and decreased gradually in both groups. Fibronectin and type I collagen expression in ASD group were stronger than control group but no significance. 3. The levels of integrin alpha2beta1 and Integrin alpha5beta1 expression were most abundant at 2 weeks and decreased gradually in both groups. No significant difference was observed in both groups. From this results, anodic oxidized titanium implants were more advantages in early stage of bone formation than control group, but have no significance in tissue responses and late bone formations. It could be stated that although anodic oxidized titanium implant possesses considerable osteoconductive potential but in osteoporotic bone condition dental implant procedure should performed after improving or treating the osteoporotic bone condition.
Animals ; Antibodies ; Collagen Type I ; Dental Implants ; Fibronectins ; Implants, Experimental ; Integrin alpha2beta1 ; Integrin alpha5beta1 ; Models, Animal ; Osseointegration ; Osteogenesis ; Osteoporosis ; Rats ; Tibia ; Titanium

PURPOSE: To report the outcome of using expandable metallic stent in the management of malignanttracheobronchial stenosis with dyspnea. MATERIALS AND METHODS: Under fluoroscopic and bronchoscopic guidance,seven patients with malignant airway stenosis were treated with ten expandable metallic stents. The cause ofstenosis was metastasis from esophageal cancer in five patients, recurrent adenoid cystic carcinoma of the tracheain one, and primary lung cancer in one. The major sites of obstruction were the trachea in four patients, the leftmain bronchus in one, the trachea and left main bronchus in one, and the trachea and both bronchi in one. Chestradiography(n=7), bronchoscopy(n=5), pulmonary function test(PFT)(n=3), and spirometry(n=1) were performed beforeand after stent placement. RESULTS: In all seven patients, the stent was successfully placed at the lesion sitesand dyspnea began to improve immediately. After the procedure, chest radiography and bronchoscopy showed anincrease in airway diameter. After stent placement, forced vital capacity (FVC) and forced expiratory volume inone second(FEV1) improved 53% and 56%, respectively. Peak flow velocity also changed from 46 L/min to 200 L/min.During median follow-up of 67(41-1565)days, one stent migration occurred. In one patient, proximal tumorovergrowth occurred, and in one, tumor ingrowth was treated with balloon dilatation. CONCLUSION: For in thepalliative treatment of malignant tracheobronchial stenosis with dyspnea, placement of expandable metal steuts issafe and effective.
Bronchi ; Bronchoscopy ; Carcinoma, Adenoid Cystic ; Constriction, Pathologic* ; Dilatation ; Dyspnea ; Esophageal Neoplasms ; Follow-Up Studies ; Forced Expiratory Volume ; Humans ; Lung Neoplasms ; Neoplasm Metastasis ; Palliative Care* ; Radiography ; Stents* ; Thorax ; Trachea ; Vital Capacity

Several studies have shown that curcumin, which is derived from the rhizomes of turmeric, possesses antimicrobial, antioxidant and anti-inflammatory properties. The antitumor properties of curcumin have also now been demonstrated more recently in different cancers. This study was undertaken to investigate the modulation of cell cycle-related proteins and the mechanisms underlying apoptosis induction by curcumin in the SCC25 human tongue squamous cell carcinoma cell line. Curcumin treatment of the SCC25 cells resulted in a time- and dose-dependent reduction in cell viability and cell growth, and onset of apoptotic cell death. The curcumin-treated SCC25 cells showed several types of apoptotic manifestations, such as nuclear condensation, DNA fragmentation, reduced MMP and proteasome activity, and a decreased DNA content. In addition, the treated SCC25 cells showed a release of cytochrome c into the cytosol, translocation of AIF and DFF40/CAD into the nuclei, a significant shift in the Bax/Bcl-2 ratio, and the activation of caspase-9, caspase-7, caspase-6, caspase-3, PARP, lamin A/C, and DFF45/ICAD. Furthermore, curcumin exposure resulted in a downregulation of G1 cell cycle-related proteins and upregulation of p27KIP1. Taken together, our findings demonstrate that curcumin strongly inhibits cell proliferation by modulating the expression of G1 cell cycle-related proteins and inducing apoptosis via proteasomal, mitochondrial, and caspase cascades in SCC25 cells.
Apoptosis* ; Carcinoma, Squamous Cell* ; Caspase 3 ; Caspase 6 ; Caspase 7 ; Caspase 9 ; Cell Cycle Checkpoints* ; Cell Death ; Cell Line* ; Cell Proliferation ; Cell Survival ; Curcuma ; Curcumin ; Cytochromes c ; Cytosol ; DNA ; DNA Fragmentation ; Down-Regulation ; Humans ; Proteasome Endopeptidase Complex ; Rhizome ; Tongue* ; Up-Regulation